| NPI | 1508480195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: CA 5696) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TX 215783) |
| Enumeration Date | 2020-05-30 |
| Last Update Date | 2026-02-26 |